Monitorage non invasif de l'hémoglobine par voie cutanée

Serum hemoglobin measurement is a valuable tool to assess blood losses and to guide transfusion. The blood red cells count is the gold standard for haemoglobin measurement. The time needed to obtain the results, and the costs of repeated measurements are the main limits for using this technique for monitoring. The azide-methaemoglobin reaction (Hémocue®) is a frequently used point-of-care method in France. Its precision is ±1.5% compared to the red cells count. A large variability of results is likely to be due to the lack of homogeneity of capillary blood sampling. A recent method of haemoglobin measurement, spectrophotometry (Masimo Corporation®), is based on the emission of light of different wavelengths using a finger sensor. A good correlation and precision and a limited bias are documented for this method compared to red cells count. Transcutaneous haemoglobin monitoring is still under evaluation, but the first results are promising.